Pathophysiology and treatment of premenstrual syndrome

Pathophysiology and treatment of premenstrual syndrome - Joseph F. Mortola Premenstrual syndrome is a well-defined entity in which affective and somatic symptoms occur repetitively in temporal relationship to the luteal phase of the menstrual cycle. Within this decade, techniques have become available that permit accurate diagnosis and management of the disorder. Extensive evidence suggests that the disorder is result of the interaction of cyclic changes in estrogen and progesterone levels with neurotransmitter systems. Serotonin and γ-aminobutyric acid appear to be especially important. Synthetic hormone analogues that disrupt the cyclic ovarian production of estrogen and progesterone, such as gonadotropin releasing hormone agonists or danazol, and pharmarologic agents that modulate central serotonin and γ-aminobutyric acid activity, such as selective serotonin-reuptake inhibitors and benzodiazapines, have therapeutic efficacy in rigorous and reproducible studies.